A new framework for evaluating potential risk of back disorders due to whole body vibration and repeated mechanical shock.

A number of studies have examined the potential relationship between exposure to occupational vibration and low back pain associated with operation of vehicles. Only a handful of studies, however, have attempted to differentiate between the relative contributions of the steady state and transient mechanical shock components (the latter also being known as 'jarring and jolting', 'high acceleration event', 'multiple shocks' and 'impact') of the vibration exposure. The primary objective of this paper is to present a review of current studies that examine mechanical shock, present a case for the importance of evaluating both steady state and mechanical shock components and propose a new framework for evaluating the health effects due to occupational vibration exposure. A computerized bibliographical search of several databases was performed with special reference to the health effects of mechanical shock in relation to lower back disorders. Based on the analysis, eight experimental studies and nine epidemiological studies with relevance to exposure to 'mechanical shock' were identified. These studies suggested that rough vehicle rides are prevalent and that repeated exposure to mechanical shock may increase the risk of lower back pain. There is an urgent need for assessing the health effects of mechanical shocks in epidemiological studies. In particular, the new ISO 2631-5: International Organization for Standardization 2004 standard for shock exposure assessment should be evaluated with regard to musculoskeletal health effects.